Injures, wounds, and burns can be categorized by their depth of penetration into the skin.
Superficial wounds or burns, previously known as first degree, are similar to sunburns and heal in a few days without any sequelae. These typically involve the epidermis.
Partial-thickness wounds or burns, previously known as second degree, will typically involve the epidermal skin layer as well as varying depths of the dermis. These blister and are painful.
Full thickness, previously called third degree, involve both the epidermis and the dermis down to the subcutaneous fat and will not heal spontaneously without severe scarring and most often are treated by surgical excision and skin grafting. These burns are often painless (after initial injury) as the nerves and blood supply are destroyed.
Of note, there are times when wound depth cannot be initially diagnosed clinically.
A patterned wound or injury is one that has a distinct pattern that may reproduce the characteristics of the object causing the injury. The pattern may be caused by contacting the body with an object/implement or by contacting the body with a patterned surface.
The implement used in a scald burn is a hot substance such as water or oil. In this case, the implement moves, as liquid moves, and that must be accounted for when assessing the injury pattern.
There are many different types of scald burns that can occur accidentally (for example, spill injuries from hot liquids) and nonaccidentally.
An immersion can also occur accidentally and nonaccidentally. An immersion burn occurs when the body is submerged in a hot substance for a period sufficient to cause a burn to areas of the body in contact with that substance. There typically are areas of injury and areas of sparing. The pattern that develops is dependent on what the body is submerged in, for how long, at what temperature, as well as the position of the body when submerged.
While patterned injuries/burns should raise concern, the diagnosis of accidental/nonaccidental injury does not rely on the pattern in isolation.
Many medical conditions can mimic patterned injuries and, therefore, it is important to always maintain and explore a differential diagnosis.